Remote DRG Auditor: MS-DRG & APR-DRG Excellence

DaMar Staffing; Springfield (IL); On-site; USD 93,000 - 160,000; Full time

Benefits offered by this job

Comprehensive benefits package

Incentive and recognition programs

Equity stock purchase

401k contribution

Job summary

Elevance Health is seeking a DRG Coding Auditor to audit inpatient medical records and generate high quality recoverable claims across multiple lines of business. The role emphasizes ICD-10 coding expertise and DRG accuracy through clinical reviews of documentation.

The position supports virtual full-time work with mandatory in-person training sessions; hybrid/alternate locations may be considered for commuting candidates. Salary range reflects location and experience.

Qualifications

• Requires AA/AS or 5+ years of experience in claims auditing, quality assurance, or recovery auditing.
• Certifications in RHIA, RHIT, CCS, CIC, or CCDS are required or preferred.
• Requires 5 years of experience with ICD-9/10CM, MS-DRG, AP-DRG and APR-DRG.

Responsibilities

• Audits inpatient medical records and generates high quality, recoverable claims.
• Performs clinical reviews to evaluate coding and DRG accuracy.
• Reviews DRG coding via medical records and attending physician statements.
• Identifies new claim types for potential recoveries beyond current concepts.

Skills

ICD-10 coding

MS-DRG

AP-DRG

APR-DRG

Education

AA/AS or 5 years claims auditing experience

BA/BS preferred

RHIA/RHIT/CCS/CIC/CCDS certifications

Job description

Elevance Health is seeking a DRG Coding Auditor to audit inpatient medical records and generate high quality recoverable claims across multiple lines of business. The role emphasizes ICD-10 coding expertise and DRG accuracy through clinical reviews of documentation.

The position supports virtual full-time work with mandatory in-person training sessions; hybrid/alternate locations may be considered for commuting candidates. Salary range reflects location and experience.